The document provides a comprehensive overview of menstruation, detailing its natural phases, related hormonal changes, and health implications. It discusses the characteristics of menstrual cycles, potential issues like delayed periods, dysmenorrhea, and abnormal bleeding, as well as hygiene practices and the importance of consulting healthcare providers for irregularities. Additionally, it addresses conditions such as PCOS and the impacts of menopause on women's health.

1. Menstruation

2. Menstruation/ Menses/ periods is-
•A natural process
•NOTHING TO BE ASHAMED OF
•A protective mechanism in human body-
to avoid unwanted pregnancies
to plan a healthy pregnancy

3. Natural process to help women bear children when desired

4. Lifespan of a woman is divided into three phases
„ FIRST Phase -birth to puberty. During this period,
reproduction related organs are inactive.
SECOND Phase -onset of puberty (9-16 years) to the onset
of menopause (45-50 years).
• First menstrual cycle is known as menarche.
• Permanent stoppage of the menstrual cycle in old age is
called menopause
• During this 35 years of reproductive age, women can
menstruate and reproduce. „
THIRD Phase- after menopause to the rest of the life

5. • Menstruation marks the beginning of puberty in girl children
• Puberty= when a young girl slowly starts becoming a woman
• Several changes take place in the body beginning at puberty
• Puberty can be attained any time in between 9 to 16 years

6. Changes at puberty
• Breast development
• Hip size enlargement
• Hair growth at
• Underarms
• Genitals
 Acne occur on skin

7. • Menarche= the first menstruation
• Menopause= end of menstruation
• Normally, menarche occurs after 2 years of beginning of breast growth
• Menarche age can depend upon mothers age at menarche too
• It also depends on physical development of a girl

8. The science
behind
menstruation

11. • After ovulation, if pregnancy does not occur, the thickened endometrium is shed.
• This is expelled out through vagina along with blood and tissue fluid.
• The process of shedding and exit of uterine lining along with
blood and fluid is called menstruation or menstrual bleeding.
• It lasts for about 3 to 7 days. This period is called menstrual period or menses.
• The day when bleeding starts is considered as the first day of the menstrual cycle

12. • Life of egg after ovulation= 1-2 days
• Life of sperm in female genital tract= around 4 days
• Maximum chances of pregnancy/fertilisation=
during the 3 days before or on the day of ovulation
• No day of menstrual cycle is 100% safe from pregnancy
• Always use contraceptives- video available in hindi/English on JIL doc
Chances of pregnancy

13. Why is it a cycle? Why does it repeat ?
• When periods (menstruations) come regularly, this is called the
menstrual cycle.
• Having regular menstrual cycles is a sign that important parts
of your body are working normally.
• The menstrual cycle provides important body chemicals, called
hormones, to keep you healthy.
• It also prepares your body for pregnancy each month.

14. How much blood is lost per cycle?
• 2-4 tablespoons of blood is lost in menstruation = 30-60ml per cycle

15. How long is a normal menstrual cycle?
• A cycle is counted from the first day of 1 period to the first day
of the next period.
• The average menstrual cycle is 28 days long.
• Cycles can range anywhere from 21 to 35 days in adults and
from 21 to 45 days in young teens.
• A variation of 3-5 days between cycles is normal.

16. Why is my period delayed?
• In the first 2-3 years after attaining menarche- irregular periods are
common.. Later it becomes regular with age
• If it exceeds >3 months between two periods= should consult doctor
• At any age.. For delayed periods ----always rule out pregnancy first
• Other common causes of delayed periods=
• Any recent health problem, sudden weight loss, stress, too much
exercise.

17. Problems related to menstruation

18. AMENORRHEA -lack of a menstrual period
• Young women who haven't started menstruating by age 16
• Women and girls who haven't had a period for 90 days, even if they
haven't been menstruating for long
• Causes can include: • Pregnancy • Breastfeeding • Extreme weight loss •
Eating disorders • Excessive exercising • Stress • Serious medical
conditions in need of treatment
• In some cases, not having menstrual periods can mean that your ovaries
have stopped producing normal amounts of estrogen which can affect
your overall health.
• Hormonal problems, such as those caused by polycystic ovarian syndrome
(PCOS) or serious problems with the reproductive organs, may be involved.
• It’s important to talk to a doctor if you have this problem.

19. Premenstrual syndrome (PMS) is the symptom of stress that appears
before the onset of menstruation. It is also called premenstrual stress
syndrome, premenstrual stress or premenstrual tension.
It lasts for about 4 to 5 days prior to menstruation.
Symptoms appear due to salt and water retention caused by estrogen.
Common Features 1. Mood swings 2. Anxiety 3. Irritability 4.
Emotional instability 5. Headache 6. Depression 7. Constipation 8.
Abdominal cramping 9. Bloating (abdominal swelling).

20. Reason for body pains during periods?
• Excess production of some chemical hormones (prostaglandins) in
body

21. Before some days of periods/ during periods

22. Also mood and behavior changes
• These are normal

23. • Menstrual symptoms are the unpleasant symptoms with discomfort, which
appear in many women during menstruation. These symptoms are due to
hormonal withdrawal, leading to cramps in uterine muscle before or during
menstruation.
• Common Menstrual Symptoms 1. Abdominal pain 2. Dysmenorrhea (menstrual
pain) 3. Headache 4. Occasional nausea and vomiting 5. Irritability 6. Depression
7. Migraine (neurological disorder, characterized by intense headache causing
disability).

24. Remedies-
1. Hot
fomentation at
site of pain
with hot cloth
or bottle in
cloth
or taking bath
with warm water

25. 2. by gently massaging area of pain
3. by herbal drink made with ginger/ cumin
4. consuming food rich in iron
5. drink more water- avoid coffee/tea
6. decrease salt and sugar
7. light exercise activity/ walking
8. yoga to relieve pain

27. Eat well, be active

28. Dysmenorrhea- painful periods, including severe cramps
• Most teens with dysmenorrhea do not have a serious disease, even though the
cramps can be severe.
• In older women, the pain is sometimes caused by a disease or condition such as
uterine fibroids or endometriosis.
• Some over-the-counter pain medicines like Ibuprofen can also help.
• If these methods don’t relieve your pain or the pain interferes with work or
school, you should see a doctor.

29. Abnormal uterine bleeding — vaginal bleeding
that’s different from normal menstrual periods
It includes: • Bleeding between periods • Bleeding after sex • Spotting
anytime in the menstrual cycle • Bleeding heavier or for more days
than normal • Bleeding after menopause
• Treatment for abnormal bleeding depends on the cause. In both
teens and women nearing menopause, hormonal changes can cause
long periods along with irregular cycles. Even if the cause is hormonal
changes, you may be able to get treatment. You should keep in mind
that these changes can occur with other serious health problems,
such as uterine fibroids, polyps, or even cancer.
• See your doctor if you have any abnormal bleeding.

30. When should I see a doctor about my period?
• You have not started menstruating by the age of 16.
• You have not started menstruating within 3 years after breast growth began, or if
breasts haven't started to grow by age 13.
• Your period suddenly stops for more than 90 days.
• Your periods become very irregular after having had regular, monthly cycles.
• Your period occurs more often than every 21 days or less often than every 35 days.
• You are bleeding for more than 7 days.
• You are bleeding more heavily than usual or using > 1 pad or tampon every 1 to 2 hours.
• You bleed between periods.
• You have severe pain during your period
• You suddenly get a fever and feel sick after using tampons. (Toxic Shock Syndrome)

31. How often should I change my pad or tampon?
You should change a pad before it becomes soaked with blood.
Each menstruator decides for themself what works best.
You should change a pad/tampon at least every 6 to 8 hours even if its
not full.

32. Why does menstrual blood smell bad?
• Menstrual blood doesn’t have any bad smell.. It’s the same as the
blood inside our body
• After coming in contact with pad/air and
• Chemical reactions take place due to which
• a smell may be there

33. Smell can be prevented by changing pad on time

34. Blood discharged during menstruation is impure or dirty?
• No because Menstruation blood doesn’t release toxins or impurity
from the body..
• This blood is the inner lining of uterus shed every cycle when
pregnancy doesn’t happen in the cycle
• This blood is fresh and is the same as the blood inside the body

35. White discharge?
• Some white discharge is normal
• It happens in everyone
• Discharge amount and form
varies throughout the cycle
• Go to doctor if-
• Smells bad
• Excess discharge
• Other color discharge

36. General hygiene tips?
• Daily bathing and washing genitals is necessary during periods too
• Always cleaning genitals from front to back, to avoid infection
• To use Washed and Dry undergarments and clean – dry menstrual
absorbents only to avoid infections

37. Should we use vaginal wash?
• Only when prescribed by doctor
• No chemical product should be used inside vagina as it can cause harm
• To clean external genitalia skin- normal bathing soap is enough
• Vagina has self cleansing mechanism
• Good bacteria in vagina maintain a pH of 4.5 with lactic acid
• Hence bad bacteria cant grow in vagina
• No chemical product should be used inside vagina as it can cause harm
• To clean external genitalia skin- normal bathing soap is enough
• Only when infections happen this balance is unsettled and need external
intervention
• Before puberty, after delivery, in infections and in menopause the pH is high and
infections can happen

38. Menstruation and Anemia
• You can have anemia if you often feel- tired, weak, giddy, look pale, don’t feel
energetic
• Get your hemoglobin level checked; Normal Hb= >12 g/dl
• Healthy diet and active lifestyle is needed
• Diet rich in iron= Rajma-chhole- spinach-groundnuts
• Eat local and seasonal fruits-vegetables
• Take iron supplements as advised on blood check up results
• Future consequences of anemia= complications in pregnancy and labour and even
malnourished baby

39. PCOD = polycystic ovarian disease
• Due to hormone
imbalance
Irregular periods
Excess body hair
Weight gain
Infertility
To prevent it-
Healthy lifestyle
Diet and exercise

40. Perimenopause (between 45- 55 years)

42. A word on menopause- a
life with low estrogen
• Transition period-
• Osteoporosis -low bone density and bone fragility
• Heart Disease
• Sexual Dysfunction- vaginal dryness, irritation, painful sex
• Incontinence- increased urge to urinate, painful urination,
or accidental leakages, postmenopausal women may have
more frequent urinary tract infections
• Depression

43. • Family support
• Eat healthy
• Stay active
• Have hobbies
• Yoga/meditation
*calcium
supplement
* Soyabean in diet

44. More questions??
• Please post them in comment section.